Bipolar disorder is a chronic, episodic condition characterized by unstable mood, with episodes of depression or mania. The term “euthymia” refers to normal mood, whereas “dysthymia” (or depression) and “mania” describe pathological departures from the normal mood state. These episodes are often accompanied by changes in circadian rhythms, distorted or psychotic thinking, and potential vulnerability to adverse life events due to their symptoms. Individuals suffering from manic episodes are often pressured, intense, grandiose and disinhibited. Unusual intensity of interests or activities is common, such as starting lots of projects or maintaining an intense focus on a single task for excessive periods of time. Often, sleep is dramatically reduced with little or no apparent associated tiredness. Impulse control is generally impaired during a manic phase, and euphoria or hypersexual behaviors are common. Please see the depression section on this site for a detailed description of major depressive episodes.
Presently, there is no known mechanism to cure bipolar disorder. However, in recent years we have learned a great deal about how and why bipolar disorder develops, with implications for how to potentially prevent or mitigate the onset of symptoms. The management of bipolar disorder is focused on the concept of recovery from the condition, in which lifestyle management and treatments target the reduction, resolution, and prevention of episodes and symptoms whenever possible. New research also implicates inflammation, blue-wavelength light exposure, and certain stressful or traumatic triggers as precipitants to bipolar mood episodes.
Establishing an accurate diagnosis is essential to determining the most appropriate course of treatment. For individuals with a true diagnosis of severe bipolar disorder, the treatment commonly includes psychotropic medications including “mood stabilizers” such as lithium or “antipsychotic” medications, which have mood-stabilizing properties themselves in addition to being effective in the treatment of psychosis. Long-term treatment is generally necessary to prevent subsequent episodes from occurring, particularly because active episodes of mania or bipolar depression are thought to be neurodegenerative over time, causing a “kindling effect” in which subsequent mood episodes may become more frequent, last longer, and become more difficult to treat. Management of lifestyle and circadian rhythms is essential to minimizing the disruptive nature of bipolar mood episodes, and treatment should be directed toward reducing harm to the individual who suffers from the condition.